MX2011003192A

MX2011003192A - Joint implant.

Info

Publication number: MX2011003192A
Application number: MX2011003192A
Authority: MX
Inventors: Frank Bleistein
Original assignee: Taurus Gmbh & Co Kg
Priority date: 2008-09-25
Filing date: 2009-09-10
Publication date: 2011-07-29
Also published as: RU2478352C2; EP2339992B1; WO2010034287A3; DE202008012749U1; AU2009295391B2; ES2537816T3; DE112009003312A5; AU2009295391A1; KR20110060917A; RU2011116074A; KR101296555B1; WO2010034287A2; EP2339992A2; PL2339992T3

Abstract

Joint implant (1) comprising an upper and a lower implant part (2, 3), which are connected to each other by at least one joint, wherein a top side of the upper implant part and a bottom side of the lower implant part can be placed against bones to be connected to each other in an articulated manner and supported, wherein the upper and/or the lower implant parts each comprise a portion of the joint region providing the joint, and wherein a connecting means (4) is provided which connects the upper and lower implant parts to each other to form a combined assembly, while enabling movement of the joint. Each of the upper and/or lower implant parts comprises a contact part (5, 8) which faces the respective bone and can be attached thereto and which provides the top or bottom side of the implant, and further comprises a joint part (6, 9) which can be attached to the contact part and comprises the joint region of the implant part. As an alternative, or in addition, the connecting means (4) extends substantially parallel to the longitudinal axis of the implant and is mounted in a holder (26, 27) of the joint region of the upper and/or lower implant parts, said holder being open on the side facing the bone, wherein the holder can be covered at least partially or at least substantially fully by a cover element which can be displaced transversely to the longitudinal axis of the implant.

Description

IMPLANT The invention relates to an articulated implant with an upper part and an implant lower part joined together with at least one joint, with the upper part of the implant, with its upper side, and the lower part of the implant, with its side lower, can be placed and supported on bones that must be joined together in an articulated manner, and being that the upper and / or lower part of the implant have a part of the articulated areas that form the joint, and that means of union that articulates in an articulated way the upper and lower part of the implant forming a continuous group, allowing an articulated movement.

This type of articulated implants is used, for example, as an intervertebral disc prosthesis to link the vertebrae of a vertebral column together. The implant can present in it one or several articulated areas that allow, independently of one another, an articulated movement of the adjoining areas in each case of the implant, for example, rotating or tumbling movements among themselves, The articulation is shaped like a cardan joint. For the implantation process it has been convenient to join together the different parts of the implant, for example, by means of the appropriate joints by bolts and pivots.

On the other hand, it is necessary to adapt the implant to the corresponding anatomical conditions and in turn allow a simple manipulation of the implant in the preamble and / or during implantation. In this case, it may be necessary to adapt the implant to bones of different sizes with support surfaces of the implant of different sizes, and / or with distances different from the bone joining areas with each other, for example, if the implant is used in different vertebrae of a vertebral column or in patients of different sizes and / or weights, to different articulated movements such as different angles of rotation depending on the respective anatomical and similar particularities.

In addition, the implant must be able to be handled safely and easily during implantation and to have a long life in the implanted state, especially to withstand high mechanical stresses.

Also, the implant must have a structure as simple as possible, which applies both for the simple manufacture and also for the simple manipulation of the implant in a sterilization and / or a simple integration in the body of the respective patient.

Therefore, the invention is based on the objective of providing an articulated implant that can be easily adapted to different anatomical conditions, is easy to handle and has a long life in the implanted state.

The objective is achieved according to the invention by means of an articulated implant according to claim 1, in which the upper and / or lower part of the implant has a support part oriented towards the corresponding bone and can be fastened thereto, which is preferably formed as a plate, and an articulated part attachable to the previous one, which includes the articulated area of the implant part. The upper and / or lower articulated part is preferably formed as a separate element and for its attachment to the respective supporting part can change its position at least relative to it. In this way, the articulated area and the support area of the part of the implant with the bone can conform independently to each other and adapt to the respective ones anatomical conditions, being that these two parts can then be joined together to form the respective part of the implant.

In this way, the support part can also provide a continuous support area for the bone, which is not interrupted, for example, by an articulated part separation line and support part and / or other breaks or interruptions. This separation line can be arranged, for example, laterally on the part of the implant. In this way, the support part can be projected continuously on the entire side of the implant facing the bone support surface. The support part and the articulated part are preferably separated along a surface or plane transverse or perpendicular to the longitudinal axis of the implant. This facilitates the integration of the implant part to the bone. Furthermore, in this way, the connecting means between the articulated part and the support part can be fastened, for example, with a widening of the same head type between the two parts. In general, the bone-side area of the articulated part may have a housing for the attachment means, which may be open to the side facing the bone, so that an area open towards the bone of the housing of the connecting means is at least partly covered by the support part. Alternatively or simultaneously, the connecting means can be fixed to the articulated part by means of a support part or be secured against position changes or not to be released. Since the housing of the joining means in the articulated part is covered at least partially or completely by the bearing part resting on the bone, the implant can be handled in a particularly safe manner and can be implanted for a long time.

The objective is also achieved alternatively or simultaneously when the joining means, which extends essentially parallel to the longitudinal axis of the implant, is held in an open housing towards the bone side of the articulated area of the upper part and / or below the implant, and when the housing can be covered at least partially by a cover element that can be displaced transverse to the longitudinal axis of the implant, the cover element can be formed as a support part that can be supported on the bone and support the implant against the bone.

Preferably, the articulated part can be fastened to the support part of the corresponding articulated part with a joining means disposed therein.

The connecting means can penetrate at least two or all of the articulated parts of the implant, for example, the upper and / or lower articulated part or in each case two contiguous articulated parts and possibly with articulated interaction of the implant with each other. The connecting means can secure the respective articulated parts on the longitudinal axis of the implant with absorption of the pulling force.

Preferably, the respective articulated part is clamped in a positive connection in the corresponding bearing part of the upper and / or lower part of the implant, in particular by means of a locking connection, the positive connection preferably being detachable. Optionally, the articulated part and the support part of the respective implant part can also be permanently joined to each other, for example, by adhesion or welding. In general, the articulated part attached to the supporting part is fixed in its position relative to it and can be moved together with the supporting part with respect to the other articulated part.

Preferably, the articulated part and the support part can pass guided to the required position with respect to each other, in which they must be permanently joined to each other. For this purpose, guide elements in each case corresponding to each other can be provided in the articulated part and in the support part.

Preferably, the upper and / or lower articulated part can rotate relative to one another about the longitudinal axis of the implant and about the longitudinal axis of the attachment means. In this way, the connecting means can generally extend at least essentially in the direction of the longitudinal axis of the implant.

Preferably, the joining means is made possible with displacement relative to the upper and / or lower articulated part, in a direction transverse to the longitudinal axis of the implant. In this way an articulated joint according to the respective anatomical conditions is possible. The possibility of displacement of the elements relative to each other can be obtained through the appropriate means in the articulated part, for example, by providing an elongated hole in them; the means can be limited to the articulated part, so that a conditioning of the supporting part is not necessary. The support part can cover partially or totally these means in the articulated part that allow the displacement with respect to the respective adjacent bone.

Preferably, the support part and its corresponding articulated part can be fastened together by means of positive connection, in particular through interlocking means; eventually, both parts can also be permanently joined to each other, for example, by a joining of material such as adhesion or welding. This connection can be made after fastening the joint part to the articulated part. Preferably, the support part and the articulated part are releasably connected to each other, possibly also permanently. This applies in each case for at least one or preferably for the two parts of the implant.

The articulated part can essentially be formed as a plate and preferably resting flat on the corresponding support part. The articulated part and the support part are joined together preferably fixed to the place and without possibility of modification of the position. The part The articulated part can extend essentially over the whole width and / or the entire length as the support part, in each case referred to the main plane of the same, possibly up to the lateral fastening areas in one of the two elements that can be used for the subjection of both elements to each other.

The support part and the corresponding articulated part of the respective part of the implant can be shaped in such a way that they can be coupled together at least essentially by transverse displacement with respect to the longitudinal axis of the implant. In general, in this way the clamping direction for fastening the support part and the articulated part to each other may be different from the main direction of the implant and / or the longitudinal axis thereof, which is in the direction of union of the bones by joining together in an articulated manner. For this purpose, the support part and / or the articulated part can have an axial guide along which the two elements can be moved guided to the required position with respect to each other. Also, in the support part and / or the articulated part a stop can be provided that defines the required position of both parts between each other.

Preferably, the support part and the corresponding articulated part are detachably fastened to each other, the support part and the articulated part being fixed in their required position with respect to each other by interlocking means. The releasable fastening means can be accessed and released preferably from at least one of the lateral surfaces of both parts, ie, from a direction transverse or essentially perpendicular to the longitudinal axis of the implant, for example, from the surface dorsal and / or lateral. Preferably, the joining of the articulated part and the supporting part is possible by the action of a tool on the side of the articulated part, other than the support area of the bone of the supporting part.

The support part, possibly also the articulated part, can have for the attachment to the other element a bag-like housing for the corresponding element, which at least establishes a bridge to the corresponding element with a partial area. The bridging area can be formed as a clamping area, which can interact with a clamping element of the corresponding element. In it, an element of The washing of the articulated part may be fixed to the bridging area of the supporting part, or the bridging area may also be arranged in the articulated part and the holding element or the washing element which interacts with it may be arranged in the support part. In general, the bag-shaped housing of the respective part can be turned laterally into a guide, in particular into an axial guide, along which the corresponding element can be moved to its required position to fix the support part and the corresponding articulated part. The articulated part and the support part may have overlapping partial areas, for example, in the manner of a dovetail guide or similar notches, in order to absorb large tensile forces in this direction.

Preferably, the joining means is formed by at least two releasable elements forming a joint on the longitudinal axis of the implant or, preferably, they can be permanently joined to each other, for example, by an adhesion bond and / or by welding. One or both parts of the joining means can be passed through the side of the articulated element facing the bone through a through hole thereof, of Thus, the areas oriented to the adjacent element in each case are joined together, which can eventually "protrude" from the respective articulated element in the direction of the other element. In general, the housing of the connecting means of the articulated element can have an indentation or narrowing of the cross-section receiving a pressure from behind the enlarged holding area, for example, in the form of a head of the connecting means or of a part of the same.

The attachment of the connecting means to the two parts of the implant, in particular to the articulated elements or, optionally, also to the support parts thereof, can preferably be carried out permanently, for example by means of a permanent connection of both parts of the connecting means, whereby a continuous articulated element can be obtained. In this, one or both of the end areas of the joining means can be able to change their position with respect to the corresponding part of the implant or articulated element, for example, they can rotate and / or move transverse to it, for example, by means of the arrangement described above. of the respective end area of the joining means in an elongated hole of the part of the implant or the part articulated The joining area of both parts of the connecting means can be generally designed as a pivot-pin connection. Under the circumstances, however, the above can also be done by means of a final area of the fastening means fastened with the possibility of changing position to an articulated part, for example, by means of a positive connection, since the opposite end area is fixed without possibility of change of position in the other articulated part that interacts.

The joining area of the two elements of the connecting means can have access from the side facing the support part of the articulated element, the joining area with the removed support part being able to project from the articulated part towards the outside or arranged in an open cavity towards the respective support part and, in this way, have access by means of the attack to the cavity. Thus, the joining tool can approach the point of attachment in the longitudinal axis of the implant. With the support part disassembled, the two elements can be permanently joined to each other, for example by welding, in particular by laser welding. After the permanent joining of both parts of the element, the support part can be fastened to the articulated element. The support part can partially or completely cover the housing of the articulated part for the joining means. The joining area of the joining means in the articulated part may be encapsulated at least essentially by the housing of the articulated part and the supporting part secured thereto. In this way, the support part and the respective articulated part can hold the attachment means permanently in each case permanently.

Preferably, the connecting means is fixed in such a way to the two parts of the implant and to the articulated elements, that the two parts of the implant are fixed together with play on the longitudinal axis of the implant and on the longitudinal axis of the connecting means . In this way, the two parts of the implant can perform a rotational, rolling or turning movement with one another or with respect to an intermediate part arranged between them, with this movement of the joint the two parts of the implant being permanently in contact with each other. contact with each other or in each case with the intermediate part. In the foregoing, the joining means may be arranged with a head-like widening in a housing of the respective part of the implant or articulated part. In this way, the game allows a relative movement of the head with respect to the housing. If necessary, the parts of the implant can also be connected to each other without any play on the longitudinal axis of the implant via the connecting means, if the holding area of the connecting means and the articulated part are shaped correspondingly, for example. , with the respective radii of curvature, which, however, costs from the point of view of construction.

The implant may have an upper and lower articulated part, which come into direct contact or interact with each other forming an articulated joint. In this, the two articulated parts can rotate with each other in the manner of a spherical joint or perform a rolling or turning movement with each other. Preferably, an intermediate element is provided between the articulated parts of the upper and lower part of the implant, which interacts in each case in an articulated manner with the articulated part of the upper and lower part of the implant. In this way, the intermediate element can change its position in an articulated manner with respect to the upper and / or lower articulated part (i.e. with respect to the articulated part of the upper and / or lower part of the implant), for example, by a turning movement (for example, in the manner of a spherical joint), a rolling movement or a turning movement. In this case, the intermediate element can be designed essentially as a plate-like element and the surfaces facing the respective articulated parts of the intermediate element can optionally also have a different cross-sectional contour and can be, for example, convexed, for example, concave or convex Preferably, at least one or both surfaces of the intermediate element facing the adjacent articulated parts can be flat, essentially parallel orthogonal. The flat surfaces of the intermediate element can be disposed at least essentially perpendicular to the joint axis of the two parts of the implant. The articulated surfaces of the articulated parts can be formed at least partially as a sphere or cylinder sections. If a rolling movement is possible, a medium cylinder section can follow flat areas, so that with the delimitation of the rolling movement there are flat support areas of the articulated parts each other or in each case with an intermediate piece. Correspondingly, if a turning movement is possible, at the middle turning edge, flat areas can follow, so that with the delimitation of the turning movement there are flat support areas of the parts articulated with each other or in each case with an intermediate part. . The same applies to a rotary movement. The holding areas of the articulated element and the supporting part, for example, the interlocking means interacting therewith, are preferably arranged radially and / or axially outside these support areas.

With the interaction of the upper and lower part of the implant and of the articulated part with the intermediate element, two articulated areas of the implant can be formed in each case. Preferably, the two articulated areas allow a turning, rolling or turning movement in different directions that can enclose an angle, for example, of 90 °. The foregoing applies preferably to the neutral position of both parts of the implant or of the parts articulated with each other. The support parts of both parts of the implant are preferably not congruently shaped, but in such a way that they can be held in the same direction in the parts articulated, for example, by displacement in the main plane of the parts of the implant and of the support parts, and in this position, the directions of rotation, rolling or turning of the parts of the implant enclose an angle, preferably of 90 °. Preferably, the two parts of the implant are formed with the possibility of rotating with one another about the longitudinal axis of the implant, so that also the directions of rotation, rolling or turning of the two parts of the implant can enclose different angles to each other.

Preferably, the intermediate element, which can be shaped in particular in the form of a plate, is penetrated by the connecting means to join together the upper and lower part of the implant and the corresponding articulated elements. In the above, the connecting means can be arranged in the intermediate part without the possibility of displacement in the longitudinal and / or transversal direction of the connection means or with a fixed position. If the connecting means consists of two parts, they can be supported in each case in the intermediate part, especially on the surfaces thereof facing the articulated parts, preferably with corresponding bearing surfaces, and thus surround the part intermediate.

The upper and / or lower part of the implant and / or the intermediate element disposed therebetween can be formed at least essentially in the form of plate elements. In particular, the bearing surfaces facing the respective bone of the upper and / or lower part of the implant can be formed at least essentially continuous and closed, so that in particular the growth of bone material in the supporting part or the housing of the connecting means in the articulated element and / or the intermediate element. However, the bearing surfaces of the support parts can be shaped in a structured manner to promote the growth of bone material.

The invention is described below with the help of an exemplary embodiment and is illustrated by the figures. They show: Figure 1, an exploded view of an implant according to the invention.

Figure 2, a cross section of an implant according to Figure 1.

Figure 3, a side view of the implant according to Figure 2.

Figures 1 to 3 show a modality of an articulated implant 1 according to the invention, with an upper part and a lower part 2, 3 of implant, wherein the upper part 2 of the implant can be supported with an upper side 2a, and the lower part 3 of the implant, with its lower side 3a, in each case in the areas of bone support, especially the vertebral bodies abutting the base plates, to join them in an articulated manner. A connection means 4 is also provided, which joins together the two parts 2, 3 of the implant forming a continuous element and allowing an articulated movement thereof. The upper part 2 of the implant consists of a support part 5 that has the upper side 2a of the part of the implant that can be supported on the bone, and an articulated part attached to the support part 5, preferably separated, which provides the articulated area 7 of the upper part of the implant. The lower part 3 of the implant correspondingly has a support part 8 that provides the lower side 3a, as well as an articulated part 9 attached to it, preferably separate, which provides the articulated area 10 of the lower part of the implant. The union of the parts of the implant and the articulated parts can let go in each case.

In principle, the two articulated areas 7, 10 of the upper and lower part of the implant can interact directly with each other forming an articulated joint. According to the embodiment, between the two parts 2, 3 of the implant, however, an intermediate part 11 is provided, which has an upper and lower side 12, 13 oriented to the upper and lower support part 5, 8, which they interact respectively with the articulated surfaces 16, 17 of the articulated areas 7, 10, resting on them, to thereby form two articulations 14, 15 of the implant. In the above, the upper and lower side 12, 13 of the intermediate part 11 are made flat and arranged preferably parallel orthogonally to each other. The articulated surfaces 16, 17 can be rotated in each case in relation to the surfaces of the intermediate part 11, for which the articulated surfaces 16, 17 have in each case curved areas at the center, preferably bulged in the shape of circular arc, like articulated areas.

On the sides of the areas that allow the articulated movement, in this case the areas 7, 10 shaped as rolling areas, follow support areas 20, 21 shaped in each case preferably flat, provided in the upper and lower articulated part, and which preferably allow a flat support on the upper side and lower part of the intermediate part and, in turn, delimit the articulated movement. The support areas 20, 21 of the upper and lower part of the implant can present in the neutral position of these parts, that is, in the case of the support surfaces arranged perpendicularly to the longitudinal axis of the implant, in each case an inclination different from the longitudinal axis 22 of the implant, which in turn may coincide with the longitudinal axis 23 of the joining means 4 In this, the upper and lower articulated part can be differentiated in terms of the conformation of the articulated areas, for example, in terms of the radii of curvature or curvature of the average rolling areas and / or the inclination of the support areas 20, 21 to the longitudinal axis of the implant following laterally. The conditioning is carried out according to the anatomical needs. The upper and lower support part 5, 8 can be made in general with the same construction and independent of the modality. The various elements, that is to say, the upper and lower supporting part 5, 8, the upper and lower articulated part 6, 9 and the intermediate part 11, can be essentially formed as plate elements.

The upper and lower parts 2, 3 of the implant are formed with the possibility of turning about the longitudinal axis 23 of the connecting means, between themselves and with respect to the intermediate part. The two parts 2, 3 of the implant can be arranged in such a way that they can carry out a movement, for example a turning, rolling or turning movement, about an axis, both axes being able to form an angle of 90 ° between yes and preferably also with respect to the longitudinal axis of the implant.

According to the embodiment, the connecting means 5 is formed in two parts with a bolt 4a and a housing pivot or sleeve 4b. In the clamped state, these are supported with their support areas 4c, 4d in the form of a crown, on the upper and lower side 12, 13 of the intermediate part 11 and surround it without play. The bolt 4a and the housing mag 4b can be permanently joined together in the front attachment area 4e (see Figure 2), for example, by laser welding. The union, by For example, laser radiation can be carried out with the support part at least partially disassembled or completely disassembled and the connection can be made at least essentially from the longitudinal direction of the connecting means or from the longitudinal axis of the implant.

The enlarged connecting areas 24, 25 in the form of the head of the connecting means 4 are arranged here in housings 26, 27 of the two articulated parts, the housings having elongated holes 28, 29 allowing a lateral displacement of the two parts 2, 3 of the implant along the longitudinal axis of the attachment means. The elongated holes extend in this case in the longitudinal direction of the areas 18, 19 which allow the articulated movement (performed here as rolling areas). With this rolling movement, a type of "sliding" of the rolling area by the respective surface of the intermediate part 11 can occur simultaneously, which can occur if the internal side walls of the housing of the joining means (or, the side walls) of the elongated holes along their end areas in the longitudinal direction, see reference 30 rotated correspondingly at 90 ° in the upper part of the implant), in a rotational or rolling movement of the bearing part with respect to the intermediate piece, come into contact until then with the connecting means 4, for example, since the two areas 20, 21 have a different inclination or extend with different length in the direction of the middle area of the respective articulated area or rolling area 18, 19. Also a "glide" of this type, which may be overlapped with a Rolling movement is still understood here as "rolling", although a rolling movement without "sliding" can also be carried out.

The support parts 5, 8 are in each case detachably connected to the respective articulated parts 6, 9. The support parts 5, 8 are connected in each case by means of positive connection, in particular by means of locking, with the articulated parts 6, 9. For this, the articulated parts 6, 9 have interlocking projections 32 which interact with the corresponding locking cavities 33 of the support parts 5. In this way, when the supporting parts have been integrated into the bone, if necessary the articulated parts can be uncoupled or released of the support parties. The articulated parts 6, 9 can be displaced transverse or perpendicular to the longitudinal axis 22 of the implant, preferably in the main plane H of the support parts 5, to be fixed thereto. For this, the support parts 5 have axial guides 34, which can be found laterally. in the articulated parts 6, 9 in the clamping movement thereof. The retaining means and locking housings 33 of the support parts are in this case arranged in a bag-shaped housing 35 which can comprise a front area of the articulated parts 6, 9 or a front area in the forward direction the lateral areas of the articulated parts. The interlocking tabs 32 of the articulated parts 6, 9 hold underneath the bridging area 36 of the bag-like housing. The advance movement of the articulated parts can be delimited by stops, for this, the bridging area 36 and / or the front ends 37 of the axial guide 34, can serve as stops for the articulated parts in order to determine their required position . Due to the conditioning of the interlocking unions, these can be unlocked by a tool acting from one direction essentially transverse or perpendicular to the longitudinal axis 22 of the implant. With the notches 38 in the support parts, provided in this case in the axial guides 34, more precisely in the two end areas thereof, partial areas of the articulated parts 6, 9 overlap, for example, the interlocking tabs 32 and / or the laterally protruding areas 39, provided in this case in the end areas opposite the locking tongues. With these positive joining means, the joint between the bearing and the articulated parts can absorb large tensile forces on the longitudinal axis of the implant.

In their required position, the support parts partially cover the fastening areas of the connecting means 4 and the housings in the articulated parts for just these areas of fastening with the respective bone or, preferably, in at least essentially total form, of so that for the bones a continuous support surface is provided in each case. In the foregoing, the support parts may have in their central area a certain depression 40 (see Figure 2), so that a clearance results between the front ends 41 (see Figure 1) of the attachment means 4 and the surfaces internal parts of the support parts and, in this way, an articulated movement of the parts of the implant with respect to the intermediate part is possible.

Claims

1. An articulated implant with an upper part and an implant lower part joined together with at least one joint, the upper part of the implant, with its upper side, and the lower part of the implant, with its lower side, can be placed and resting on bones that must be joined together in an articulated manner, and where the upper and / or lower part of the implant has a part of the articulated areas that form the joint, and where a joining means is provided that joins articulated form the upper and lower part of the implant forming a continuous group, allowing an articulated movement, characterized in that the upper and / or lower part of the implant has a support part oriented in each case towards the corresponding bone and can be fastened thereto, the which provides the upper and lower side of the implant, and an articulated part attachable to the support part, which includes the articulated area of the part of the implant. implant, and / or because the attachment means, extending essentially parallel to the longitudinal axis of the implant, is held in an open housing towards the bone side of the articulated area of the upper and / or lower part of the implant, and in that the housing can be covered at least partially or at least substantially completely by a cover element displaceable transverse to the longitudinal axis of the implant .

2. The implant according to claim 1, characterized in that the connecting means penetrates the upper and / or lower articulated part and fixes them on the longitudinal axis of the implant with absorption of the tensile force.

3. The implant according to claim 1 or 2, characterized in that the articulated part is held in positive connection in the support part of the upper and / or lower part of the implant.

4. The implant according to any of claims 1 to 3, characterized in that the joining means can be displaced in relation to the upper and / or lower support part and / or to the articulated part, transverse to the longitudinal axis of the implant.

5. The implant according to any of claims 1 to 4, characterized in that the joining means presents two parts, which can be clamped or permanently clamped together on the longitudinal axis of the implant forming a joint.

6. The implant according to any of claims 1 to 5, characterized in that the part of the implant and its corresponding articulated part can be fastened to each other through positive joining means, preferably through washing means.

7. The implant according to any of claims 1 to 6, characterized in that the upper and / or lower articulated part is shaped like a plate and rests on the support part.

8. The implant according to any of claims 1 to 7, characterized in that the upper and / or lower support part and the corresponding articulated part can be fastened to each other in each case in such a way that they can be coupled together at least essentially by transverse displacement to the longitudinal axis of the implant.

9. The implant according to claim 8, characterized in that the support part and / or the articulated part have a guide axial along which the two elements can be moved guided to their required position with respect to each other.

10. The implant according to any of claims 1 to 9, characterized in that the support part or the articulated part has a fastening means that can be fastened to the other element and because the clamping area of one of the two elements bypasses the other, forming at least partially a bag-like accommodation.

11. The implant according to any of claims 1 to 10, characterized in that the support part and the corresponding articulated part are formed in such a way that when the articulated part is held in its position in the support part, they permanently hold the means of Union.

12. The implant according to any of claims 1 to 11, characterized in that an intermediate part is provided between the articulated part of the upper and lower part of the implant, which interacts in each case articulated with the articulated part of the upper part. and inferior of the implant.

13. The implant in accordance with claim 12, characterized in that the intermediate element is penetrated by the joining means.

14. The implant according to any of claims 1 to 13, characterized in that the articulated joint between the parts of the implant is formed in such a way that both articulated parts can be rolled together or towards an intermediate element disposed between them, or can be turned laterally between themselves or against the intermediate element, forming an articulated joint.

15. The implant according to any of claims 1 to 14, characterized in that the articulated parts of the upper and / or lower part of the implant can be joined through the connecting means in a continuous manipulable element, which can be attached to the part of the implant. higher; and / or lower of the implant with the attachment means disposed in each case therein.

16. The implant according to any of claims 1 to 15, characterized in that the attachment means or a part thereof can be coupled to the articulated part from the side of the support part and / or the attachment means can be coupled or join permanently, from the side of the bone to be joined, with the part articulated that houses it. SUMMARY OF THE INVENTION The invention relates to an articulated implant with an upper part and an implant lower part joined together with at least one joint, with the upper part of the implant, with its upper side, and the lower part of the implant, with its side lower, can be placed and supported on bones that must be joined together in an articulated manner, and being that the upper and / or lower part of the implant have a part of the articulated areas that form the joint, and that means of union that articulates in an articulated way the upper and lower part of the implant forming a continuous group, allowing an articulated movement. According to the invention, the upper and / or lower part of the implant has a support part oriented in each case towards the corresponding bone and can be fastened thereto, which provides the upper and lower side: of the implant, and a hinged articulated part to the support part, which includes the articulated area of the implant part. Alternatively or additionally, the joining means, extending essentially parallel to the longitudinal axis of the implant, is held in an open housing towards the bone side of the articulated area of the upper and / or lower part of the implant, and because the housing can be covered at least partially or at least essentially completely by a cover element movable transverse to the longitudinal axis of the implant.